Esthetics of Facial Reconstruction following Mohs Surgery

James F. Thornton, MD

I am honored to serve as the guest editor for my fifth issue of Seminars in Plastic Surgery, all focused on soft tissue facial reconstruction. Through my experience editing journals and over 20 years dedicated to facial reconstruction, I have had the opportunity to identify some key insights.

First, I am convinced that we have developed effective surgical algorithms for most soft tissue facial reconstruction challenges, yielding predictable and satisfactory results when supported by adequate time, technical skills, and resources. I remain hopeful that ongoing advancements in cancer treatment will render many Mohs surgery resections and reconstructions obsolete in the next 15 to 20 years.

Second, it is crucial for surgeons to strive for the highest level of surgical skill and to practice without exception at that level. The quality of our specialty is often compromised by nonsurgeons and mid-level practitioners who lack the necessary training to achieve our results. By making exceptional outcomes our standard, we uphold the quality of care our patients deserve.

To practice at this high level, we must assess what constitutes an exceptional result. One of the papers included in this issue begins to address this by exploring the concepts of predictable outcomes and the restoration of facial symmetry.

Finally, the role of surgical education is vital in maintaining and advancing our high standards as practitioners. While there are more educational resources available than ever before, surgical residency programs face increasing nonclinical demands on trainees' time. Achieving the requisite case volume and complexity requires discipline in preparation, execution, and critical analysis of results—what we refer to as “deliberate practice.”

I would like to thank the editors for allowing me to contribute to another seminar, and I hope the readers find it valuable.

Publication History

Article published online:
17 December 2024